Lecture II Flashcards

1
Q

True or false: IBD can affect the eye

A

True

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2
Q

What is retinitis pigmentosum?

A

Genetic (or acquired) disease of the rods of the eye that causes them to degenerate slowly over time, with peripheral vision usually being lost first

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3
Q

What are the three major ROS facts that should be obtained with the eye?”

A
  • Disturbances of vision
  • Pain or discomfort of the eye
  • Abnormal eye secretions
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4
Q

What is amaurosis?

A

partial or total blindness without visible change in the eye, typically due to disease of the optic nerve, spinal cord, or brain.

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5
Q

What is Amaurosis Fugax?

A

a temporary loss of vision in one eye caused by ischemia to the retina. It may also be caused by embolization from atherosclerotic plaques in the ipsilateral internal carotid artery.

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6
Q

Floaters and photopsia = ?

A

Retinal detatchment

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7
Q

What is photopsia?

A

Flashes of light

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8
Q

What is diplopia?

A

Double vision

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9
Q

What is epiphora?

A

Overflow tearing

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10
Q

What etiologies do the following secretions usually indicated with the eye:

  • Purulent
  • Mucous
  • Serous
A
Purulent = bacterial
Mucous = allergic
Serous = viral
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11
Q

What is iritis?

A

(anterior uveitis) Inflammation of the anterior chamber and the iris

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12
Q

You should always check the visual acuity of patients except for one instance. What is it?

A

Chemical burns–irrigate the eye immediately

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13
Q

What is the best way to check for visual acuity– the (best/worst) (Corrected/uncorrected) (monocular/binocular)

A

Best corrected monocular vision

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14
Q

What is the order of vision checks you should do if a patient cannot read the top letter/number on an eye chart?

A

Visual fields
Hand motion
Light perception

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15
Q

What is cortical blindness?

A

brain is affected so there is no processing of visual information, but reflexes are intact

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16
Q

What is a scotoma?

A

Blind spot

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17
Q

What is a hemianopia?

A

Loss of 1/2 VF

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18
Q

What is homonymous?

A

Either right or left VF

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19
Q

What are scintillating scotomas?

A

Jagged lines that appear often with migraine HAs are are not usually accompanied by visual loss

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20
Q

What are the eyebrow findings with hypothyroidism?

A

Thinning

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21
Q

What does the swinging flashlight test assess for?

A

Afferent reflex

22
Q

What are the characteristics that should be obtained when inspecting the eye, instead of using PERRLA?

A
Size
Equal
Round
Central
Reactive
23
Q

What is anisocoria?

A

Difference in the size of pupils

24
Q

How do you perform the swinging light test? What does this assess for?

A

Swing light between eyes in a dark room–tests for afferent response of each pupil

25
Q

What happens to the pupils when changing from far to near vision?

A

Constriction

26
Q

When is checking EOMs particularly important?

A

If there is a complaint of diplopia

27
Q

From superior to inferior, which muscle is being assessed at each of the three cardinal direction of gaze on the temporal side?

A

SR
LR
IR

28
Q

From superior to inferior, which muscle is being assessed at each of the three cardinal direction of gaze on the Nasal side?

A

IO
MR
SO

29
Q

Damage to CN III results in what ophthalmologic defects?

A

Eye looks down and out; ptosis, pupillary dilation, and loss of accommodation

30
Q

Damage to CN IV results in what defects?

A

Eye moves upward, particularly with contralateral gaze and head tilt toward the side of the lesion

31
Q

Damage to CN VI results in what defects?

A

Medially directed eye that cannot abduct

32
Q

What is the CN that innervated the sensation to the eye?

A

CN V

33
Q

What is arcus corneae?

A

a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris

May be a sign of hypercholesterolemia

34
Q

What are the two major, general causes of lens subluxation?

A

trauma

Systemic

35
Q

What is the classic CT disorder that leads to lens subluxation?

A

Marfan’s syndrome

36
Q

How do you communicate lesions in the retina? (location, size)

A

Clock position relative to the optic disc

Size relative to the disc diameter

37
Q

What causes AV nicking?

A

Increased pressure in the arteries compresses the veins

38
Q

What are scleral crescents?

A

lighter area in the optic disc–normal variant

39
Q

What are pigmented crescents?

A

Pigmentation around the optic disc–normal variant

40
Q

What is papilledema?

A

Optic disc swelling (usually bilateral) d/t increased ICP

Causes an enlarged blind spot and elevated optic disc with blurred margins on fundoscopic exam

41
Q

True or false: disc edema = papilledema

A

false–papilledema is 2/2 increased ICP

42
Q

How do preretinal hemorrhages appear on fundoscopic exam?

A

Like an air-fluid level on CT (kinda)

43
Q

How, roughly, do you distinguish between cotton wool spots and hard exudates?

A

Cotton wool spots are softer than hard exudates

44
Q

What is the normal eye pressure?

A

10-21 mmHg

45
Q

What is the gold standard test for eye pressures?

A

Goldmann

46
Q

When should patients with better than 20/20 vision be referred?

A

If there are visual complaints

47
Q

When should pts wit worse than 20/20 vision be referred?

A

Always, even in the absence of complaints

48
Q

When should pts with VA asymmetry be referred?

A

Difference of 2 lines or more

49
Q

True or false: for the most part, any fundus exam abnormality necessitates a referral to an ophthalmologist

A

True

50
Q

Eye pressure of greater than what indicates the need for referral?

A

More than 22 mmHg

51
Q

What are the components of AIDET?

A
  • Acknowledge pt with a smile
  • introduce yourself
  • Describe what you are going to do
  • Explain
  • thank you
52
Q

One eye bigger than the other in a kid = ?

A

glaucoma until proven otherwise